Automated Blood Cell Analysis

Question 1

Examine the histograms/scatterplots obtained from four major instruments for the same patient specimen (Figure 15-14,
A-D).
Compare the results, and respond to questions 1 to 4 based on the results.

1. Which printout lets the end user know at a glance that the
   results are acceptable and no manual work needs to be performed?
   a. CELL-DYN Sapphire
   b. UniCel DxH 800
   c. ADVIA 2120i
   d. Sysmex XN-series

Answer 1

d. Sysmex XN-series

Question 2

2. Which instrument printout has a system flag on the platelet
   count?
   a. CELL-DYN Sapphire
   b. UniCel DxH 800
   c. ADVIA 2120i
   d. XN-series

Answer 2

a. CELL-DYN Sapphire

Question 3

3. What do you suspect is the cause of the variation in platelet
   counting among the four instruments?
   a. Different instruments have different levels of sensitivity.
   b. All instruments use the same principle for counting
   platelets.
   c. Some instruments are susceptible to false-positive platelet flagging under certain conditions.
   d. Different instruments use different thresholds to capture
   and count platelets

Answer 3

d. Different instruments use different thresholds to capture
and count platelets

Question 4

4. Based on the overall flagging for this specimen on each instrument, should a manual differential count be performed
   for this patient?
   a. Yes, because immature granulocytes are present in the
   sample.
   b. Yes, because the WBC scatterplots are abnormal.
   c. No, because each differential count is complete with no
   system or morphology flags.

Answer 4

c. No, because each differential count is complete with no
system or morphology flags.

Question 5

5. A patient peripheral blood film demonstrates agglutinated
   RBCs, and the CBC shows an elevated MCHC. What other
   parameters will be affected by the agglutination of the
   RBCs?
   a. MCV will be decreased and the RBC count will be
   increased.
   b. MCV will be decreased and the RBC count will be
   decreased.
   c. MCV will be increased and the RBC count will be
   decreased.
   d. MCV will be increased and the RBC count will be
   increased

Answer 5

c. MCV will be increased and the RBC count will be
decreased.

Question 6

6. . Match the cell-counting methods listed with the appropriate definition:
   ____ Impedance
   _____RF
   ______Optical scatter

a. Uses diffraction, reflection, and
refraction of light waves
b. Uses high-voltage electrical waves
to measure the internal complexity of cells
c. Involves detection and measurement of changes in electrical
current between two electrodes

Answer 6

__C__ Impedance
___B__RF
____A__Optical scatter

Question 7

7. Low-voltage DC is used to measure:
   a. Cell nuclear volume
   b. Total cell volume
   c. Cellular complexity in the nucleus
   d. Cellular complexity in the cytoplasm

Answer 7

b. Total cell volume

Question 8

8. Orthogonal light scatter is used to measure:
   a. Cell volume
   b. Internal complexity of the cell
   c. Cellular granularity
   d. Nuclear density

Answer 8

b. Internal complexity of the cell

Question 9

9. On the Beckman Coulter instruments, hematocrit is a calculated value. Which of the following directly measured parameters is used in the calculation of this value?
   a. RDW
   b. Hemoglobin
   c. MCV
   d. MCHC

Answer 9

c. MCV

Question 10

10. Match each instrument listed with the technology it uses to determine WBC differential counts.

___ Abbott CELL-DYN
Sapphire

___ Siemens ADVIA
2120i

___ Sysmex XN-1000

___ Beckman Coulter
UniCel DxH 800

a. Volume, conductivity, and
five angles of light scatter
b. MAPSS technology and
three-color fluorescence
c. Peroxidase-staining absorbance and light scatter
d. Detection of forward and
side scattered light and
fluorescence

Answer 10

__B_ Abbott CELL-DYN
Sapphire

__C_ Siemens ADVIA
2120i

__D_ Sysmex XN-1000

__A_ Beckman Coulter
UniCel DxH 800